Homestead_Garrison . •
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INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER t 3..,
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PrepareroftheSalesDisclosureFo m Title
Address
Ci�(/Nuumberand(Street) T 1�^7 `
E-mail
E SELLER(S)/GRANT -arl: 1,fat AZ?
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Seller 1-Name as appears on convey nae.document Seller 2-Name as appears on conveyance document
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Address(Number and Street) Address(Number and Street)
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City,State,and ZIP Code City,State,and ZIP Code
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Under penalties of perjury,I hereby certify that this Sales D• cl, i e,' . 11 u,'es t,u f y i r--'i.l • as d lief,is true,correct
and com as requires(b l w,and is prepared in accorda w w C -1. -5. "' •al 'rroper ales isclosure Act".
Sign r of Seller Signature of Seller
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�PrimeojSeller
Sign Date(MM/DD/YYYY) Printed Name of Seller Sign Date(MM/DD/YYYY)
UYER(S GRANTEE(S)=APPLICA ION FOR TYDUON CTIS}1DENTIFY.ALL=ITEM ,`.,Lr='). •.L,_
440/7;.i 4: Agrzi o -1 J C , P
Buyer 1-Na.a as appears on co ocum Buyer 2-Name as appears on conveyance docume
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Address(Number and Street) Address(Number and Street) DEC 2 7 2019
E-mail ptratreNvmber---___ GIRSnN COUNTY AUDITCdRad
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FO'Till VR1O•ERTY. IDENTIFY ALL 0 -OSE THAT APPLY.
YES� NO CONDITION YES NO CONDITION
[2(/ ❑ 1.Will this property be the buyer's primary g.$ Q' 3.Homestead
residence? Provide complete address of primary "IQ. _II✓ 4.Solar Ener_ -eating/Cooling System
residence,including county:
❑ C 5.Wind Power P evice
Address(Number and Street) ❑ [ 6.Hydroelectric Power Device
❑ [" 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
❑ Z' 2.Does the buyer have a homestead in Indiana to be ❑ $ Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ [" 9.Would you like to receive tax statements for this
complete address of residence being vacated, propart" Provide contact information
including county: below.Please see instruction for; ore information.
Not available in all counties.)
Address(Number and Street)
^ I3•-.0I —uOti —000- • nag-022- •
City,State ZIP Code County
Primas>y 75tope owner contact name -mail
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my kno I.'• i T. _rl-beliefris ,correct
and complete as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".(Note:
Spouse information,Social Security and Driver's License/Other numbers are not necessary if no Homestead Deduction is
being filed.)
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Signature of Buyerl Signature of Buyer2/Spo use
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Printed Legal Name of Buyer 1 Sign Date(MM/DD/YYYY) Printed Legal Name of 8uyer2/Spouse Sign Date(MM/DD/YYYY)
Lasts digits of Buyer 1 Driver's State Last 5 Digits of Social Security Number Last 5 digits of Buyer 2/Spouse Driver's State Last 5 Digits of Social Security
License/ID/Other Number Number License/ID/Other Number